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A Medicaid and CHIP state plan is an agreement between a state and the Federal government describing how that state administers its Medicaid and CHIP programs. It gives an assurance that a state will abide by Federal rules and may claim Federal matching funds for its program activities. The state plan sets out groups of individuals to be covered, services to be provided, methodologies for providers to be reimbursed and the administrative activities that are underway in the state.
When a state is planning to make a change to its program policies or operational approach, states send state plan amendments (SPAs) to the Centers for Medicare & Medicaid Services (CMS) for review and approval. States also submit SPAs to request permissible program changes, make corrections, or update their Medicaid or CHIP state plan with new information.
Persons with disabilities having problems accessing the SPA PDF files may call 410-786-0429 for assistance.
Summary: proposes to add coverage language and requirements to targeted case management for the chronically mental ill to comply with 42 CFR §§ 440.169 and 441.18
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to reimburse all Mississippi Medicaid pharmacies, physicians, and non-physician practitioners 100% of the Medicare rate for the administration of an FDA-approved COVID-19 vaccine. The Division of Medicaid will reimburse Federally Qualified Health Centers (FQHCs) and Rural Health Centers (RHCs) outside of the PPS rate for administering the COVID-19 vaccine at 100% of the Medicare rate only if there is no corresponding encounter. If there is an encounter, administration of the COVID-19 vaccine is reimbursed as part of the encounter rate.
Summary: Updates the bundled composite rate for services provided in an outpatient maintenance dialysis clinic. The Dialysis Clinic reimbursement rate will be increased 1.83% per legislative appropriation.
Summary: Allows the state to transfer the administrative functions and responsibilities of personal care and respite Individual Provider (IP) management from the Department of Social and Health Services (DSHS) and Area Agency on Aging (AAA) staff to a single contracted CDE vendor, the Consumer Direct Care Washington, LLC.
Summary: Adds Medication Therapy Management (MTM) to Licensed Pharmacist Services under the Other Licensed Practitioner (OLP) benefit; remove the Treatment Authorization Request (TAR) requirement from Licensed Pharmacist Services; and updates the rate methodology for Licensed Pharmacist Services by adding rates for MTM
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is a rate increase for procedures performed by Ground Ambulance providers effective July 1, 2020 through September 30, 2020.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to implement a Specialized COVID - 19 Behavioral Health Long Term Care Bed Rate.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to suspend the collection of data for performance measures other than those identified for the Health and Welfare assurance for the Section 1915 program and notes that the data will be unavailable for this time frame in ensuing reports due to the circumstances of the pandemic.
